Eyeworld

EW CATARACT 40 December 2016 bilateral cataract (83%) and two eyes unilateral cataract (17%); 14% were female and 86% were male. The follow-up time of the oldest case was 18 months. Dr. Silva was the only surgeon. "As in many hospitals, we do not yet have a device to measure keratometry in infants but had to perform the surgery, which of course had to include lens implantation. Using the formula we developed ear- lier this year, we estimated the IOL power in a small group of patients who had good visual outcomes. This is fantastic for me because I needed a portable device but couldn't afford one. Portable devices for biometric calculation may not be available to all surgeons, especially for pediatric cataract surgeons. It's not always fea- sible to buy a portable keratometer. In Brazil, a manual keratometer may cost around $14,000. The bottom line is, if you have a reliable formula to use in pediatric patients that gives good results, you can perform good surgery. We achieved very good results, and the children all have improved vision," Dr. Silva said. The outcomes demonstrated little variation from the target refrac- tive outcomes. The results showed 0.25 degrees of variation between planned and achieved refraction in each of his 12 patients. The use of the equation was a safe and effective way to calculate biometry in chil- dren with congenital cataract for IOL implantation, and in particular for children in hospitals without the means to buy a portable keratometry device. "This surgery is meticulous and involves great training. There is a small margin for error, and every surgery becomes unique. It differs from adult surgery in the capsular elasticity and the small eye length. The surgeon needs to watch the intraoperative mobilization of the posterior capsule, inflammation con- trol during surgery, and the impor- tance of long-term lens calculations to prevent myopia," he said. "If there is a portable device available, I would use it, but in plac- es where it is not available, the for- mula defined in the study is useful and provides more accurate values, based on our population study. In older children, from 5 years up- ward, I use an IOLMaster [Carl Zeiss Meditec, Jena, Germany], but in younger patients I find the formula to be very effective." He explained that the main limitation of the study was likely to be the K value because K is measured in patients under anesthesia and without fixation. The study will be submitted for publication. "Surgical treatment for congen- ital cataract has developed over the last few decades, allowing cataract removal in children younger than 1 year. Congenital cataract deprives the retina of light during periods of greater neural plasticity, and surgery is the primary treatment to prevent amblyopia; however, it only partial- ly solves the problem because the aphakic eye has a refractive error that must be corrected," Dr. Silva said. EW Reference 1. Prado RB, et al. Congenital and develop- mental cataract: axial length and keratometry study in Brazilian children. Arq Bras Oftalmol. 2016;79:19–23. Editors' note: Dr. Silva has no financial interests related to his comments. Contact information Silva: virepm71@yahoo.com.br Simple continued from page 38 (800) 367-8327 DuPont, WA 98327 info@lacrimedics.com • www.lacrimedics.com ©2016 Lacrimedics, Inc. 1 ASCRS Clinical Survey 2015. Global Trends in Ophthalmology and the American Society of Cataract and Refractive Surgery. 2 Offer valid through April 30, 2016. Don't let 41% of your patients with OSD go untreated, especially when they need something more than artifi cial tears. Lacrimedics' VisiPlug® is FDA approved for the treatment of the Dry Eye components of varying Ocular Surface Diseases (OSD) and after surgery to prevent complications due to Dry Eye Disease. VisiPlug® - Provides approximately 180 days of occlusion. Call 1-800-367-8327 and receive 15% OFF 2 your order! (Mention promo code OSD0416.) Don't let 41% of your patients 41% of refractive or cataract surgery patients have ocular surface dysfunction levels requiring some treatment beyond artifi cial tears! 1 0.4mm 0.5mm

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